Senate Releases Draft of Opioid Crisis Package
On Wednesday, Senate Health, Education, Labor and Pensions (HELP) Committee leadership released a large package of legislation related to the opioid crisis aimed at strengthening addiction treatment access, developing non-opioid pain medications and creating new programs to curb the crisis. This package, called the Opioid Crisis Response Act of 2018, builds on the series of hearings the Committee has convened since October 2017. It also comes on the heels of opioid response strategies released by the White House and the House Energy and Commerce Subcommittee. Both the House and the Senate aim to markup their respective bipartisan legislative packages before summer.
The discussion draft of the Opioid Crisis Response Act of 2018 would:
- Reauthorize the Opioid State Targeted Response (STR) Grant Program. Currently funded at $1 billion for FY 2018, the Opioid STR grants provide states with resources to increase prevention, treatment and recovery services for opioid use disorder. Without reauthorization, this grant program will expire at the end of this fiscal year.
- Make medication-assisted treatment (MAT) available via telemedicine. The package incorporates two House Energy and Commerce Committee discussion drafts that would remove barriers to tele-prescribing for addiction and mental health treatment centers. These proposals were developed as the result of National Council efforts to work with Members of Congress to remove barriers to MAT and prescribing of certain psychiatric medications. Among other provisions, the package would open the door to telemedicine by requiring the Drug Enforcement Administration (DEA) to allow community mental health and addiction treatment centers to register with DEA to provide controlled substances, such as MAT medications and certain psychiatric medications, in compliance with the Ryan Haight Online Pharmacy Consumer Protection Act.
- Increase access to medication-assisted treatment with more prescribers. The bill would make permanent the ability for nurse practitioners and physician assistants to prescribe buprenorphine, a drug utilized in MAT. The draft also codifies physicians’ ability to prescribe the buprenorphine to up to 275 patients (earlier law limited physicians to 100 patients).
- Require HHS to issue guidance on recovery housing best practices. In consultation with the Department for Housing and Urban Development, the Department of Health and Human Services (HHS) is required to publish best practices on operating recovery housing, a supportive housing model for individuals living in recovery from addiction. HHS may also provide support to states on how to implement model laws incentivizing adherence to recovery housing best practices. This work could rely on existing state laws that incentivize recovery residence certification based on the national quality standard developed by the National Alliance for Recovery Residences (NARR).
- Spur development for new pain and addiction treatments. The National Institutes of Health (NIH) would be given special flexibility to move faster on opioid-related research to better understand opioid addiction and possible non-opioid pain relief alternatives. The FDA would also be tasked with helping to spur new medications by updating the development process for new non-addictive and non-opioid pain medicines, and by alerting companies on when these drugs could qualify for the accelerated approval process or FDA’s breakthrough designation program.
The Senate HELP Committee’s discussion draft includes no new funding, but does authorize the creation of a number of new grant programs in addition to reauthorizing funding for existing grant programs. If the package passed both chambers of Congress, Congressional appropriators would need to pass additional legislation to fund the programs. Specific funding amounts for many of the grants are still under discussion.